Sex dimorphism in the tumor microenvironment - From bench to bedside and back
Sex dimorphism in the tumor microenvironment - From bench to bedside and back
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DOI：
10.1016/j.semcancer.2022.03.007
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发表时间：
2022-10-13
影响因子：
14.5
通讯作者：
Sarhan, Dhifaf
中科院分区：
文献类型：
--
作者：
He, Fei;Furones, Andrea Rodgers;Sarhan, Dhifaf
癌症是发达国家和发展中国家死亡和痛苦的一个重要原因。癌症死亡率的关键潜在问题是延迟诊断和对治疗的抵抗。然而，生物标志物的改进代表了减轻恶性肿瘤引起的痛苦的一个重要步骤。基于精确的医学有望彻底改变全球癌症患者的诊断和治疗策略。现代方法，包括各种组学和系统生物学方法，以及先进的数字成像和人工智能，可以在患者水平上更准确地评估肿瘤特征。因此，治疗策略可以针对携带某些肿瘤特征的个体和/或患者组进行专门定制和调整。这包括免疫疗法，其基于免疫抑制性肿瘤微环境（TME）的表征，更具体地说，免疫细胞亚群的存在和活性。不幸的是，虽然越来越清楚性别强烈影响免疫调节和反应，但关于性别特异性免疫反应的差异以及这些差异如何有助于免疫抑制性TME和对免疫疗法的反应，存在知识空白。事实上，性别二态性在癌症进展中知之甚少，在当前的临床实践中通常被忽视。在这篇综述中，我们的目标是调查现有的文献，并强调现有的知识差距，以鼓励进一步的研究，这将有助于理解TME中的性别偏见免疫抑制和肿瘤进展为侵袭性和转移性疾病的驱动因素。该综述强调，需要将性别优化/性别化医学作为未来医学癌症诊断和治疗的新概念。
Cancer represents a significant cause of death and suffering in both the developed and developing countries. Key underlying issues in the mortality of cancer are delayed diagnosis and resistance to treatments. However, improvements in biomarkers represent one important step that can be taken for alleviating the suffering caused by malignancy. Precision-based medicine is promising for revolutionizing diagnostic and treatment strategies for cancer patients worldwide. Contemporary methods, including various omics and systems biology approaches, as well as advanced digital imaging and artificial intelligence, allow more accurate assessment of tumor characteristics at the patient level. As a result, treatment strategies can be specifically tailored and adapted for individual and/or groups of patients that carry certain tumor characteristics. This includes immunotherapy, which is based on characterization of the immunosuppressive tumor microenvironment (TME) and, more specifically, the presence and activity of immune cell subsets. Unfortunately, while it is increasingly clear that gender strongly affects immune regulation and response, there is a knowledge gap concerning differences in sex-specific immune responses and how these contribute to the immunosuppressive TME and the response to immunotherapy. In fact, sex dimorphism is poorly understood in cancer progression and is typically ignored in current clinical practice. In this review, we aim to survey the available literature and highlight the existing knowledge gap in order to encourage further studies that would contribute to understanding both gender-biased immunosuppression in the TME and the driver of tumor progression towards invasive and metastatic disease. The review highlights the need to include sex optimized/genderized medicine as a new concept in future medicine cancer diagnostics and treatments.